Deep Learning in Classifying Bowel Obstruction Radiographs

NCT ID: NCT06321614

Last Updated: 2024-03-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

4500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-12-31

Study Completion Date

2024-12-31

Brief Summary

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Background: Accurate labeling of obstruction site on upright abdominal radiograph is a challenging task. The lack of ground truth leads to poor performance on supervised learning models. To address this issue, self-supervised learning (SSL) is proposed to classify normal, small bowel obstruction (SBO), and large bowel obstruction (LBO) radiographs using a few confirmed samples.

Methods: A few number of confirmed and a large number of unlabeled radiographs were categorized based on the ground truth. The SSL model was firstly trained on the unlabeled radiographs, and then fine-tuned on the confirmed radiographs. ResNet50 and VGG16 were used for the embedded base encoders, whose weights and parameters were adjusted during training process. Furthermore, it was tested on an independent dataset, compared with supervised learning models and human interpreters. Finally, the t-SNE and Grad-CAM were used to visualize the model's interpretation.

Detailed Description

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Conditions

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Digestive System Disease Polyp of Colon Bowel Disease

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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patients with normal abdominal radiographs

patients with normal abdominal radiographs, which were confirmed by extra imaging examinations and clinical data. The imaging examinations comprised CT, magnetic resonance imaging (MRI) and colonoscopy in the subsequent 72 hours, while clinical data included recent hospital admission information and surgical operation notes.

No interventions assigned to this group

patients with small bowel obstruction radiographs

patients with small bowel obstruction radiographs, which were confirmed by extra imaging examinations and clinical data. The imaging examinations comprised CT, magnetic resonance imaging (MRI) and colonoscopy in the subsequent 72 hours, while clinical data included recent hospital admission information and surgical operation notes. In terms of location, small-bowel obstruction (SBO) involves the duodenum, jejunum, and ileum

No interventions assigned to this group

patients with large bowel obstruction radiographs

patients with large bowel obstruction radiographs, which were confirmed by extra imaging examinations and clinical data. The imaging examinations comprised CT, magnetic resonance imaging (MRI) and colonoscopy in the subsequent 72 hours, while clinical data included recent hospital admission information and surgical operation notes. In terms of location, large-bowel obstruction (SBO), involves the cecum, colon, and rectum.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. The hospital imaging system looked for plain abdominal standing films diagnosed as intestinal obstruction or normal between 2022 and 2024
2. Aged 18 to 80 years
3. The main complaint was gastrointestinal symptoms

Exclusion Criteria

1. Image interference, fuzzy performance, difficult to distinguish
2. Non-gastrointestinal symptoms were the main complaint
3. Supine, prone, or lateral decubitus radiography
4. Paralytic obstruction, closed loop obstruction, et al
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The First Affiliated Hospital of Soochow University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rui Li, MD

Role: STUDY_DIRECTOR

The First Affiliated Hospital of Soochow University

Locations

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TheFirst Affiliated Hospital of Soochow University

Suzhou, Jiangsu, China

Site Status

Countries

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China

References

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Markogiannakis H, Messaris E, Dardamanis D, Pararas N, Tzertzemelis D, Giannopoulos P, Larentzakis A, Lagoudianakis E, Manouras A, Bramis I. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcome. World J Gastroenterol. 2007 Jan 21;13(3):432-7. doi: 10.3748/wjg.v13.i3.432.

Reference Type RESULT
PMID: 17230614 (View on PubMed)

Cheng PM, Tran KN, Whang G, Tejura TK. Refining Convolutional Neural Network Detection of Small-Bowel Obstruction in Conventional Radiography. AJR Am J Roentgenol. 2019 Feb;212(2):342-350. doi: 10.2214/AJR.18.20362. Epub 2018 Nov 26.

Reference Type RESULT
PMID: 30476452 (View on PubMed)

Kim DH, Wit H, Thurston M, Long M, Maskell GF, Strugnell MJ, Shetty D, Smith IM, Hollings NP. An artificial intelligence deep learning model for identification of small bowel obstruction on plain abdominal radiographs. Br J Radiol. 2021 Jun 1;94(1122):20201407. doi: 10.1259/bjr.20201407. Epub 2021 Apr 27.

Reference Type RESULT
PMID: 33904763 (View on PubMed)

Frager D. Intestinal obstruction role of CT. Gastroenterol Clin North Am. 2002 Sep;31(3):777-99. doi: 10.1016/s0889-8553(02)00026-2.

Reference Type RESULT
PMID: 12481731 (View on PubMed)

Cappell MS, Batke M. Mechanical obstruction of the small bowel and colon. Med Clin North Am. 2008 May;92(3):575-97, viii. doi: 10.1016/j.mcna.2008.01.003.

Reference Type RESULT
PMID: 18387377 (View on PubMed)

ten Broek RP, Strik C, Issa Y, Bleichrodt RP, van Goor H. Adhesiolysis-related morbidity in abdominal surgery. Ann Surg. 2013 Jul;258(1):98-106. doi: 10.1097/SLA.0b013e31826f4969.

Reference Type RESULT
PMID: 23013804 (View on PubMed)

Vanderbecq Q, Ardon R, De Reviers A, Ruppli C, Dallongeville A, Boulay-Coletta I, D'Assignies G, Zins M. Adhesion-related small bowel obstruction: deep learning for automatic transition-zone detection by CT. Insights Imaging. 2022 Jan 24;13(1):13. doi: 10.1186/s13244-021-01150-y.

Reference Type RESULT
PMID: 35072813 (View on PubMed)

Chen Y, Mancini M, Zhu X, Akata Z. Semi-Supervised and Unsupervised Deep Visual Learning: A Survey. IEEE Trans Pattern Anal Mach Intell. 2024 Mar;46(3):1327-1347. doi: 10.1109/TPAMI.2022.3201576. Epub 2024 Feb 6.

Reference Type RESULT
PMID: 36006881 (View on PubMed)

Li G, Togo R, Ogawa T, Haseyama M. Self-supervised learning for gastritis detection with gastric X-ray images. Int J Comput Assist Radiol Surg. 2023 Oct;18(10):1841-1848. doi: 10.1007/s11548-023-02891-5. Epub 2023 Apr 11.

Reference Type RESULT
PMID: 37040011 (View on PubMed)

Other Identifiers

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2022098

Identifier Type: -

Identifier Source: org_study_id

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